Onset of Prinzmetal's angina two years following sudden death syndrome survival.

A patient who was resuscitated after an episode of ventricular fibrillation without myocardial infarction outside the hospital developed angina for the first time two years later. Although the clinical pattern did not fulfill all of the criteria of Prinzmetal's variant angina and was found to correspond with episodes of ventricular tachycardia, we feel that Prinzmetal's angina can be implicated as the mechanism of previos ventricular fibrillation. During the patient's second hospitalization, angiography demonstrated a single, moderately stenotic, right coronary lesion which was bypassed. Immediately postoperatively, the patient developed ventricular fibrillation requiring more than two hours of cardiopulmonary resuscitation. Six months after bypass surgery, she experienced an inferior wall myocardial infarction. She is presently asymptomatic with normal heart size.